斯鲁利单抗致小细胞肺癌患者中毒性表皮坏死松解症

Serplulimab induced toxic epidermal necrolysis in a patient with small cell lung cancer

1例52岁男性小细胞肺癌患者,使用化疗TC方案(白蛋白紫杉醇+卡铂)联合斯鲁利单抗免疫治疗后10 d,出现全身皮肤发红、浮肿、身体多处(颈部、胸部、足部)大小不等的水疱等症状,考虑为斯鲁利单抗导致的中毒性表皮坏死松解症。停用斯鲁利单抗,给予甲泼尼龙、氯雷他定、依巴斯汀和辅助外用黏膜保护等对症治疗10 d后,皮炎基本消退,破裂的水疱结痂痊愈。患者改用安罗替尼,未再使用免疫治疗。

A 52-year-old male patient with small cell lung cancer developed symptoms of systemic skin redness,edema,and blisters of varying sizes in multiple parts of the body(neck,chest,and feet)10 days after receiving chemotherapy with TC regimen(albumin paclitaxel and carboplatin)combined with serplulimab for immunotherapy.It is suspected to be toxic epidermal necrolysis caused by serplulimab.After discontinuing serplulimab and receiving symptomatic treatments such as methylprednisolone,loratadine,ebastine,and adjuvant topical mucosal protection for 10 days,the dermatitis basically subsided and the ruptured blisters were scabby.The patient switched to anlotinib and did not receive immunotherapy again.